Objective: To establish the prevalence of anticoagulant (AC) treatment, the indications, and the quality of care in primary health care.
Design: A cross-sectional study, in which patients on AC treatment were identified from laboratory records. The main and second indications for AC treatment and the last value of the AC-test were taken from medical records.
Setting: Eight Finnish health centres with a total population of 182091 inhabitants.
Results: A total of 1255 patients on AC treatment were identified, 48% of them men. The mean age was 68.9 years. The age-adjusted prevalence of AC treatment was 0.65%. The commonest main indication was atrial fibrillation (38%). It was the main or second indication in 591 patients (age-adjusted prevalence 0.30%). The next commonest main indication was deep vein thrombosis (15%), followed by pulmonary embolism (8%). A total of 274 (22%) patients were anticoagulated for cerebral circulatory disturbances. 86% of the latest prothrombin time values fell within recommended ranges.
Conclusion: The prevalence of AC treatment in Finland seems to be high. The proportion of patients with atrial fibrillation is high, differing from the results in other countries. The monitoring of AC-treatment as the general practitioner's responsibility functions well. The quality of care is good, even in older age groups.
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http://dx.doi.org/10.3109/02813439609024172 | DOI Listing |
Zhonghua Nei Ke Za Zhi
February 2025
Department of Neurology, the Eighth Medical Center of Chinese PLA General Hospital, Beijing100091, China.
Trousseau's syndrome is a thromboembolic disorder associated with malignancies, with cerebral infarction and hemorrhage representing common central nervous system complications in patients with cancer. This report details the diagnosis and treatment of a patient with gastric adenocarcinoma at our institution who concurrently developed cerebral infarction and subarachnoid hemorrhage. We performed a comprehensive literature review in the Wanfang and PubMed databases, searching for relevant studies on Trousseau's syndrome, cerebral embolism, and subarachnoid hemorrhage.
View Article and Find Full Text PDFBMJ Open
January 2025
Department of General Practice, University College Cork, Cork, Ireland
Objectives: To describe the prevalence of sub-optimal monitoring for selected higher-risk medicines in older community-dwelling adults and to evaluate patient characteristics and outcomes associated with sub-optimal monitoring.
Study Design: Retrospective observational study (2011-2015) using historical general practice-based cohort data and linked dispensing data from a national pharmacy claims database.
Setting: Irish primary care.
Rev Clin Esp (Barc)
January 2025
Medicina Interna, Hospital Clínico Universitario de Valladolid, Universidad de Valladolid, Valladolid, Spain.
Pulmonary embolism (PE) is a disease with a rising incidence rate. This article presents the recommendations for the diagnosis and treatment of PE of the Thromboembolic Disease Group of the Spanish Society of Internal Medicine (SEMI). The main objective is to facilitate decision making to improve the diagnostic and therapeutic approach based on published evidence.
View Article and Find Full Text PDFTrends Cardiovasc Med
January 2025
Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart and Chest Hospital, Liverpool, United Kingdom; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; Medical University of Bialystok, Bialystok, Poland.
Atrial fibrillation (AF) and atrial myopathy are recognized contributors to cardiovascular morbidity, particularly ischemic stroke. AF poses an elevated risk of thrombogenesis due to irregular heart rhythm leading to blood stasis and clot formation. Atrial myopathy, marked by structural and functional alterations in the atria, is emerging as a crucial factor influencing thromboembolic events, independently of AF.
View Article and Find Full Text PDFLancet Neurol
February 2025
Department of Medicine, McMaster University, Population Health Research Institute, Hamilton, ON, Canada.
Background: People with subclinical atrial fibrillation are at increased risk of stroke, albeit to a lesser extent than those with clinical atrial fibrillation, leading to an ongoing debate regarding the benefit of anticoagulation in these individuals. In the ARTESiA trial, the direct-acting oral anticoagulant apixaban reduced stroke or systemic embolism compared with aspirin in people with subclinical atrial fibrillation, but the risk of major bleeding was increased with apixaban. In a prespecified subgroup analysis of ARTESiA, we tested the hypothesis that people with subclinical atrial fibrillation and a history of stroke or transient ischaemic attack, who are known to have an increased risk of recurrent stroke, would show a greater benefit from oral anticoagulation for secondary stroke prevention compared with those without a history of stroke or transient ischaemic attack.
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